Daniel Cervenka had been fighting lung cancer for almost a year, with some success, by the spring of 2001.
But his oncologist in New Prague didn't sugarcoat it. The cancer would come back, she said. The only question was when. In the meantime, she said, he could take a break from chemotherapy -- and its side effects -- for several months.
At the Parker Hughes Cancer Center in Roseville, he heard a different message entirely.
"They were almost like excited -- 'This is just the type of patient we want,' " recalled his widow, Judie.
Dr. Fatih Uckun, the clinic's founder, said Cervenka should begin chemotherapy immediately, records show. "They said you have to hit it aggressively," his widow said. "He didn't say, 'We'll cure you.' No. But 'This is the kind we can control.' . . . We came out of this thinking, 'You're going to be fine.' "
What followed were more than $392,000 in medical bills and 69 trips to the clinic during the next eight months -- an average of one every three days until December, when he died. The family didn't have to pay, but his health plan reimbursed the clinic about $108,000.
Experts say it's a remarkable case of excessive and inappropriate treatment. "I was amazed at the amount of tests and treatments and expenses that were generated for this poor man," said Dr. Harold Londer, one of two cancer specialists who reviewed Cervenka's records for the Star Tribune.
Dr. John H. Brown, former head of Abbott Northwestern Hospital's Piper Breast Center, agreed. "He was seen much more than was necessary," he said, ". . . far above the norm."
In a September interview, Uckun defended his treatment of patients. More recently, his lawyer declined to comment on Cervenka's case, citing privacy concerns even though the family offered to sign a waiver.
'He gave us hope'
For Cervenka, 62, a burly former farmer who ran a construction business, the Parker Hughes message appealed to his feisty spirit. It also appealed to his close-knit family, including his three grown children.
"When we met Dr. Uckun, he gave hope," said Cervenka's daughter, Terrie Schoenbauer. "We thought, 'This is an answer to our prayers.' "
Cervenka made the 84-mile round trip to Parker Hughes up to three times a week, a dozen times in May 2001 alone. "We were there all the time," Judie Cervenka said. "He said, 'I might as well just move into this damn place,' because he was there so much."
Daniel Cervenka, who kept a journal, wrote that on his first day of chemotherapy, he left home at 6:30 a.m. and finished at 9:10 p.m. "Took longer than they told me," he wrote.
Over the months, he wrote about the side effects that chemotherapy can cause. "Still have sores on my lip, tongue & throat, achy from my waist down, dizzy at times," he wrote. He noted the times he had to cancel plans with family or friends as a result. "Tonite was supper nite at Deb & Mikes, I didn't feel up to it."
By October, the repeat visits were getting wearisome. "Those people there don't know what the heck is going on," Cervenka wrote. "They called at 6:40 to say they want me back tomorrow."
The treatment exhausted him, his wife said. "He had very few good days. But we continued this regimen simply because we thought that there would be a point where he wouldn't need the chemo anymore."
The Cervenkas were told that he could take a break after Thanksgiving, and they planned a vacation. But at the last minute, the story changed. "Dr. Uckun decided you should have one more session," his wife said they were told. They canceled their trip.